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Article: Non-invasive suppression of the human nucleus accumbens (NAc) with transcranial focused ultrasound (tFUS) modulates the reward network: a pilot study.

Peng, Xiaolong / Connolly, Dillon J / Sutton, Falon / Robinson, John / Baker-Vogel, Brenna / Short, Edward B / Badran, Bashar W

Frontiers in human neuroscience

2024 Volume 18, Page(s) 1359396

Abstract: Background: The nucleus accumbens (NAc) is a key node of the brain reward circuit driving reward-related behavior. Dysregulation of NAc has been demonstrated to contribute to pathological markers of addiction in substance use disorder (SUD) making it a ... ...

Abstract	Background: The nucleus accumbens (NAc) is a key node of the brain reward circuit driving reward-related behavior. Dysregulation of NAc has been demonstrated to contribute to pathological markers of addiction in substance use disorder (SUD) making it a potential therapeutic target for brain stimulation. Transcranial focused ultrasound (tFUS) is an emerging non-invasive brain stimulation approach that can modulate deep brain regions with a high spatial resolution. However, there is currently no evidence showing how the brain activity of NAc and brain functional connectivity within the reward network neuromodulated by tFUS on the NAc. Methods: In this pilot study, we carried out a single-blind, sham-controlled clinical trial using functional magnetic resonance imaging (fMRI) to investigate the underlying mechanism of tFUS neuromodulating the reward network through NAc in ten healthy adults. Specifically, the experiment consists of a 20-min concurrent tFUS/fMRI scan and two 24-min resting-state fMRI before and after the tFUS session. Results: Firstly, our results demonstrated the feasibility and safety of 20-min tFUS on NAc. Additionally, our findings demonstrated that bilateral NAc was inhibited during tFUS on the left NAc compared to sham. Lastly, increased functional connectivity between the NAc and medial prefrontal cortex (mPFC) was observed after tFUS on the left NAc, but no changes for the sham group. Conclusion: Delivering tFUS to the NAc can modulate brain activations and functional connectivity within the reward network. These preliminary findings suggest that tFUS could be potentially a promising neuromodulation tool for the direct and non-invasive management of the NAc and shed new light on the treatment for SUD and other brain diseases that involve reward processing.
Language	English
Publishing date	2024-04-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2425477-0
ISSN	1662-5161
ISSN	1662-5161
DOI	10.3389/fnhum.2024.1359396
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Left or right ear? A neuroimaging study using combined taVNS/fMRI to understand the interaction between ear stimulation target and lesion location in chronic stroke.

Peng, Xiaolong / Baker-Vogel, Brenna / Sarhan, Mutaz / Short, Edward B / Zhu, Wenzhen / Liu, Hesheng / Kautz, Steven / Badran, Bashar W

Brain stimulation

2023 Volume 16, Issue 4, Page(s) 1144–1153

Abstract: Background: Implanted vagus nerve stimulation (VNS) and transcutaneous auricular VNS (taVNS) have been primarily administered clinically to the unilateral-left vagus nerve. This left-only convention has proved clinically beneficial in brain disorders. ... ...

Abstract	Background: Implanted vagus nerve stimulation (VNS) and transcutaneous auricular VNS (taVNS) have been primarily administered clinically to the unilateral-left vagus nerve. This left-only convention has proved clinically beneficial in brain disorders. However, in stroke survivors, the presence of a lesion in the brain may complicate VNS-mediated signaling, and it is important to understand the laterality effects of VNS in stroke survivors to optimize the intervention. Objective: To understand whether taVNS delivered to different ear targets relative to the lesion (ipsilesional vs contralesional vs bilateral vs sham) impacts blood oxygenation level dependent (BOLD) signal propagation in stroke survivors. Methods: We enrolled 20 adults with a prior history of stroke. Each participant underwent a single visit, during which taVNS was delivered concurrently during functional magnetic resonance imaging (fMRI) acquisition. Each participant received three discrete active stimulation conditions (ipsilesional, contralesional, bilateral) and one sham condition in a randomized order. Stimulation-related BOLD signal changes in the active conditions were compared to sham conditions to understand the interaction taVNS and laterality effects. Results: All active taVNS conditions deactivated the contralesional default mode network related regions compared to sham, however only ipsilesional taVNS enhanced the activations in the ipsilesional visuomotor and secondary visual cortex. Furthermore, we reveal an interaction in task activations between taVNS and cortical visuomotor areas, where ipsilesional taVNS significantly increased ipsilesional visuomotor activity and decreased contralesional visuomotor activity compared to sham. Conclusion: Laterality of taVNS relative to the lesion is a critical factor in optimizing taVNS in a stroke population, with ipsilesional stimulation providing largest direct brain activation and should be explored further when designing taVNS studies in neurorehabilitation.
MeSH term(s)	Adult ; Humans ; Magnetic Resonance Imaging/methods ; Brain/physiology ; Stroke/diagnostic imaging ; Stroke/therapy ; Neuroimaging ; Transcutaneous Electric Nerve Stimulation/methods ; Vagus Nerve Stimulation/methods ; Vagus Nerve/physiology
Language	English
Publishing date	2023-07-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2394410-9
ISSN	1876-4754 ; 1935-861X
ISSN (online)	1876-4754
ISSN	1935-861X
DOI	10.1016/j.brs.2023.07.050
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Article ; Online: The role of rTMS for patients with severe PTSD and depression.

Fryml, Leah D / Sahlem, Gregory / Fox, James / Short, Edward B

Evidence-based mental health

2018 Volume 21, Issue 1, Page(s) 39–40

MeSH term(s)	Adult ; Clinical Decision-Making/methods ; Depressive Disorder, Major/therapy ; Female ; Humans ; Stress Disorders, Post-Traumatic/therapy ; Suicidal Ideation ; Transcranial Magnetic Stimulation/methods
Language	English
Publishing date	2018-01-05
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2009065-1
ISSN	1468-960X ; 1362-0347
ISSN (online)	1468-960X
ISSN	1362-0347
DOI	10.1136/eb-2017-102819
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Article: A Preliminary Investigation Of Repetitive Transcranial Magnetic Stimulation Applied To The Left Dorsolateral Prefrontal Cortex In Treatment Seeking Participants With Cannabis Use Disorder.

Sahlem, Gregory L / Kim, Bohye / Baker, Nathaniel L / Wong, Brendan L / Caruso, Margaret A / Campbell, Lauren A / Kaloani, Irakli / Sherman, Brian J / Ford, Tiffany J / Musleh, Ahmad H / Kim, Jane P / Williams, Nolan R / Manett, Andrew J / Kratter, Ian H / Short, Edward B / Killeen, Terese K / George, Mark S / McRae-Clark, Aimee L

medRxiv : the preprint server for health sciences

2023

Abstract: Background: Cannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have a ...

Abstract	Background: Cannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have a therapeutic clinical effect when applied in serial sessions. The present study sought to preliminarily determine whether serial sessions of rTMS applied to the DLPFC had a therapeutic effect in CUD. Methods: This study was a two-site, phase-2, double-blind, randomized-controlled-trial. Seventy-two treatment-seeking participants (37.5% Women, mean age 30.2±9.9SD) with ≥moderate-CUD were randomized to active or sham rTMS (Beam-F3, 10Hz, 20-total-sessions, with cannabis cues) while undergoing a three-session motivational enhancement therapy intervention. The primary outcome was the change in craving between pre- and post-treatment (Marijuana Craving Questionnaire Short-Form-MCQ-SF). Secondary outcomes included the number of weeks of abstinence and the number of days-per-week of cannabis use during 4-weeks of follow-up. Results: There were no significant differences in craving between conditions. Participants who received active rTMS reported numerically, but not significantly, more weeks of abstinence in the follow-up period than those who received sham rTMS (15.5%-Active; 9.3%-Sham; rate ratio = 1.66 [95% CI: 0.84, 3.28]; Conclusions: This trial suggests rTMS is safe and feasible in individuals with CUD and may have a therapeutic effect on frequency of cannabis use, though further study is needed with additional rTMS-sessions and a longer follow-up period.
Language	English
Publishing date	2023-07-12
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.07.10.23292461
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Article ; Online: A preliminary randomized controlled trial of repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex in treatment seeking participants with cannabis use disorder.

Drug and alcohol dependence

2023 Volume 254, Page(s) 111035

Abstract	Background: Cannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have therapeutic clinical effects when applied in serial-sessions. The present study sought to preliminarily determine whether serial-sessions of rTMS applied to the DLPFC had a therapeutic effect in CUD. Methods: This study was a two-site, phase-2, double-blind, randomized-controlled-trial. Seventy-two treatment-seeking participants (37.5% Women, mean age 30.2±9.9SD) with ≥moderate-CUD were randomized to active or sham rTMS (Beam-F3, 10Hz, 20-total-sessions, two-sessions-per-visit, two-visits-per-week, with cannabis cues) while undergoing a three-session motivational enhancement therapy intervention. The primary outcome was the change in craving between pre- and post- treatment (Marijuana Craving Questionnaire Short-Form-MCQ-SF). Secondary outcomes included the number of weeks of abstinence and the number of days-per-week of cannabis use during 4-weeks of follow-up. Results: There were no significant differences in craving between conditions. Participants who received active-rTMS reported numerically, but not significantly, more weeks of abstinence in the follow-up period than those who received sham-rTMS (15.5%-Active; 9.3%-Sham; rate ratio = 1.66 [95% CI: 0.84, 3.28]; p=0.14). Participants who received active-rTMS reported fewer days-per-week of cannabis use over the final two-weeks of the follow-up period than those receiving sham-rTMS (Active vs. Sham: -0.72; Z=-2.33, p=0.02). Conclusions: This trial suggests rTMS is safe and feasible in individuals with CUD and may have a therapeutic effect on frequency of cannabis use, though further study is needed with additional rTMS-sessions and a longer follow-up period.
MeSH term(s)	Humans ; Female ; Young Adult ; Adult ; Male ; Transcranial Magnetic Stimulation ; Dorsolateral Prefrontal Cortex ; Prefrontal Cortex/physiology ; Substance-Related Disorders ; Double-Blind Method ; Marijuana Abuse/therapy ; Treatment Outcome
Language	English
Publishing date	2023-11-19
Publishing country	Ireland
Document type	Randomized Controlled Trial ; Clinical Trial, Phase II ; Journal Article
ZDB-ID	519918-9
ISSN	1879-0046 ; 0376-8716
ISSN (online)	1879-0046
ISSN	0376-8716
DOI	10.1016/j.drugalcdep.2023.111035
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Article ; Online: Pyrotherapy for the Treatment of Psychosis in the 21st Century: A Case Report and Literature Review.

Zuschlag, Zachary D / Lalich, Callie J / Short, Edward B / Hamner, Mark / Kahn, David A

Journal of psychiatric practice

2016 Volume 22, Issue 5, Page(s) 410–415

Abstract: The concept that fevers can improve the condition of patients with certain medical and psychiatric diseases dates back to Hippocrates. Over the centuries, it has been observed that fevers and infectious agents have been beneficial for a broad spectrum of ...

Abstract	The concept that fevers can improve the condition of patients with certain medical and psychiatric diseases dates back to Hippocrates. Over the centuries, it has been observed that fevers and infectious agents have been beneficial for a broad spectrum of diseases, including neurologic conditions such as epilepsy and psychiatric illnesses including melancholy and psychosis. Interest in the concept of fever as a treatment for disease, termed pyrotherapy or pyretotherapy, peaked in the late 1800s and early 1900s thanks to the Nobel Prize winning work of Julius Wagner-Jauregg for his studies with malaria therapy for general paralysis of the insane, now more commonly referred to as neurosyphilis. The use of inoculations of infectious agents for their fever-inducing effects in the treatment of neurosyphilis quickly spread throughout the world, and, by the 1920s, it was considered by many to be the treatment of choice for neurosyphilis as well as other psychotic disorders. However, with the discovery of penicillin for the treatment of syphilis, which coincided with the advent of convulsion-oriented practices including electroconvulsive therapy and insulin coma for the treatment of psychotic disorders, pyrotherapy soon lost favor among psychiatrists and, since the 1950s, it has largely been overlooked by the scientific community. In this article, the authors provide a brief literature review of the history of pyrotherapy and present a case report of a woman with schizoaffective disorder and severe psychotic symptoms who experienced a remarkable resolution of psychotic symptoms following an episode of bacteremia with high fever.
MeSH term(s)	Adult ; Female ; History, 20th Century ; History, 21st Century ; Humans ; Hyperthermia, Induced/history ; Hyperthermia, Induced/methods ; Neurosyphilis/complications ; Neurosyphilis/history ; Psychotic Disorders/etiology ; Psychotic Disorders/therapy
Language	English
Publishing date	2016-09-19
Publishing country	United States
Document type	Case Reports ; Historical Article ; Journal Article ; Review
ZDB-ID	2022726-7
ISSN	1538-1145 ; 1527-4160
ISSN (online)	1538-1145
ISSN	1527-4160
DOI	10.1097/PRA.0000000000000181
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Article ; Online: Healthcare Costs and Medication Adherence Among Patients with Fibromyalgia: Combination Medication vs. Duloxetine, Milnacipran, Venlafaxine, and Pregabalin Initiators.

Marlow, Nicole M / Simpson, Kit N / Vaughn, Ivana A / Jo, Ara / Zoller, James S / Short, Edward B

Pain practice : the official journal of World Institute of Pain

2017 Volume 18, Issue 2, Page(s) 154–169

Abstract: Objective: To examine medication adherence and healthcare costs for combination prescription initiators (duloxetine/milnacipran/venlafaxine with pregabalin) vs. monotherapy initiators (duloxetine, milnacipran, venlafaxine, and pregabalin) among patients ...

Abstract	Objective: To examine medication adherence and healthcare costs for combination prescription initiators (duloxetine/milnacipran/venlafaxine with pregabalin) vs. monotherapy initiators (duloxetine, milnacipran, venlafaxine, and pregabalin) among patients with fibromyalgia syndrome (FMS). Methods: Our retrospective cohort study used claims data for the South Carolina Blue Cross Blue Shield State Health Plan (SHP). Patients with FMS ≥ 18 years of age, with prescription initiation from July 1, 2007, through June 30, 2010, and SHP enrollment for 12 months pre- and post-index periods were included (combination: n = 100; pregabalin: n = 665; duloxetine: n = 713; milnacipran: n = 131; venlafaxine: n = 272). Medication adherence measures included high adherence (medication possession ratio ≥ 80%) and total supply days. Healthcare costs comprised direct medical expenditures. Propensity score methods of inverse probability of treatment weights were used to control for selection bias due to differing pre-index characteristics. Results: Odds ratios for high adherence were significantly increased (P < 0.05) among the combination cohort vs. the venlafaxine (2.15), duloxetine (1.39), and pregabalin (2.20) cohorts. Rate ratios for total supply days were significantly higher (P < 0.05) for combination vs. venlafaxine (1.23), duloxetine (1.08), and pregabalin (1.32) cohorts. Expenditures for total health care were significantly higher (P < 0.05) for combination vs. duloxetine ($26,291 vs. $17,190), milnacipran ($33,638 vs. $22,886), and venlafaxine ($26,586 vs. $16,857) cohorts. Conclusions: Medication adherence was considerably better for combination prescription initiators; however, expenditures for total health care were higher. Still, our findings suggest important clinical benefits with the use of combination prescription therapy, and prospective studies of medication adherence are warranted to examine causal relationships with outcomes not captured by healthcare claims databases.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cohort Studies ; Databases, Factual ; Drug Therapy, Combination/economics ; Drug Therapy, Combination/methods ; Duloxetine Hydrochloride/administration & dosage ; Duloxetine Hydrochloride/economics ; Female ; Fibromyalgia/drug therapy ; Fibromyalgia/economics ; Health Care Costs ; Humans ; Male ; Medication Adherence/statistics & numerical data ; Middle Aged ; Milnacipran/administration & dosage ; Milnacipran/economics ; Pregabalin/administration & dosage ; Pregabalin/economics ; Retrospective Studies ; Venlafaxine Hydrochloride/administration & dosage ; Venlafaxine Hydrochloride/economics
Chemical Substances	Pregabalin (55JG375S6M) ; Venlafaxine Hydrochloride (7D7RX5A8MO) ; Duloxetine Hydrochloride (9044SC542W) ; Milnacipran (G56VK1HF36)
Language	English
Publishing date	2017-05-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2151272-3
ISSN	1533-2500 ; 1530-7085
ISSN (online)	1533-2500
ISSN	1530-7085
DOI	10.1111/papr.12585
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Article: Non-invasive suppression of the human nucleus accumbens (NAc) with transcranial focused ultrasound (tFUS) modulates the reward network: a pilot study.

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Article ; Online: Left or right ear? A neuroimaging study using combined taVNS/fMRI to understand the interaction between ear stimulation target and lesion location in chronic stroke.

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Article ; Online: The role of rTMS for patients with severe PTSD and depression.

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Article: A Preliminary Investigation Of Repetitive Transcranial Magnetic Stimulation Applied To The Left Dorsolateral Prefrontal Cortex In Treatment Seeking Participants With Cannabis Use Disorder.

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Article ; Online: A preliminary randomized controlled trial of repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex in treatment seeking participants with cannabis use disorder.

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Article ; Online: Pyrotherapy for the Treatment of Psychosis in the 21st Century: A Case Report and Literature Review.

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Article ; Online: Healthcare Costs and Medication Adherence Among Patients with Fibromyalgia: Combination Medication vs. Duloxetine, Milnacipran, Venlafaxine, and Pregabalin Initiators.

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